Contributing authors:

Cherie Castellano, CSW is Vice President for Survivor Services at TAPS and was a member of the New York Emergency Services 9/11 Delegation to England and Ireland

Lisa Zucker, MSW is Senior Director of Education at TAPS

Bonnie Carroll is the Founder and President of the Tragedy Assistance Program for Survivors (TAPS) and recipient of the Presidential Medal of Freedom from President Barack Obama in 2015

George S. Everly, Jr., PhD, MA is on the faculty of The Johns Hopkins School of Medicine and served on the NYPD and Columbia University initiatives at Ground Zero post 9/11

The pain of loss surely extends to time immemorial. It is safe to say that the experience of grief is a universal human experience extending far prior to written records. Societal and religious traditions of lamentation are legion. The earliest written records in Western civilization are replete with mentions of grief. Evidence from the Old Kingdom of Egypt (2600 BC) suggests the mourning of a loss was a public experience involving great pomp and circumstance, especially in the case of the wealthy and ruling class. The 5th-century Greek tragedies were large‑scale public rituals for the cathartic expression of loss and trauma. The tragedies made grieving a civic experience, if not an obligation. The Nordic and Germanic traditions continued the theme of grief as a civic responsibility, but in these cases, grief was expressed in public mythological storytelling and ritualized remembrances such as funerals. With the rise of Christianity and other religions, organized public funerals spread in popularity. Grief was one of the centerpieces of the birth of psychology in the late 1800s and early 1900s. Freud’s Mourning and Melancholia (1917) marked the first formal psychological theory of grief, emphasizing the importance of “letting go” of that which was lost.

But more recently, Freud’s notion of letting go has been challenged. Reformulating the connection in a different manner (reattachment) with that which was lost is favored more than the detachment advocated by Freud (Klass, Silverman, & Nickman, 1996). So, we see the process of grieving loss has been characterized by public displays and rituals throughout history. Grieving has been understood as a process that is best shared rather than denied or hidden away. If there was one relatively recent watershed moment that concretized the notion of never forgetting, it may well be the events of September 11^th, 2001.

An Approach to Large-Scale Healing

As we approach the 25th anniversary of September 11th, we reflect on the thousands of lives lost that day, the thousands more affected by illness, and the families forever changed by the subsequent wars and military service. For example, the Tragedy Assistance Program for Survivors (TAPS) has provided support for over 100,000 bereaved family members since its inception, with 14,858 9/11-related bereaved military family members served since 9/11/2001. In order to fulfill such a mission, the approach of providing psychological support through the exclusive use of licensed mental health clinicians had to be abandoned. Peer support models were adopted instead.

The Peers

Peers may be defined as two or more people who share some common denominator, typically shared lived experiences. Individuals who have successfully navigated challenging life experiences can, with proper training, effectively serve in a peer support capacity. These peer supporters can harness the bond of shared experience to create credibility, perceived empathy, and hopefulness (SAMHSA, 2015). Peer support is recognized and endorsed by the Substance Abuse and Mental Health Administration (SAMHSA). In the wake of September 11, 2001, peers were trained and mobilized to provide support to military families, but in order to harness the power of peer support, those peer supporters were those who had experienced the pain of similar losses, but had healed.

In the TAPS approach, peers were trained in a simple three-step non-linear bereavement model:

1. Provide safety and stabilization: Offering immediate crisis intervention and acute support when grief is first activated. Creating a psychologically safe space is essential.
2. Foster a healthy grief journey: Providing supportive care, peer support, and therapy, as indicated, while individuals process strong emotions and memories.
3. Assist with making meaning: Helping individuals find purpose, honor their loved ones, and build meaningful lives moving forward.

Lesson Learned

Decades of walking alongside bereaved families confirms that peer support can be profoundly therapeutic. These same principles are now being applied in the Ukraine. So, as we find ourselves looking back, we see a three-fold revelation: 1) grief is a process best seen as a journey, 2) the journey is best undertaken with companionship, and 3) the best companions are those who have made a similar journey before. There is healing in being able to sit with someone who does not need grief explained, who understands that there is no timetable for mourning, and who can offer living proof that it is possible to survive devastating loss while continuing to carry love forward.

Twenty-five years after 9/11, and in the case of TAPS, a core promise remains unchanged: no one who is grieving the death of someone who served our nation should ever have to walk that road alone. Survivors caring for survivors has been at the heart of helping from the beginning, and it remains one of the most powerful expressions of healing, hope, and the enduring bonds of love. This promise can be made to all survivors of loss regardless of its origin. So, it seems the ancients got it right. They understood that healing from loss should never be a solitary experience. The support of others, especially peers, teaches the essential lessons of love and hope.